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Individual

DR. IWONA KONCZAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071-007687
IL
103TC0700X
Clinical Psychologist
20042297A
IN
103TC0700X
Clinical Psychologist
Primary
25632
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IL7807
MEDICARE ID
IL
Enumeration date
11/13/2007
Last updated
10/07/2022
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